家庭无创通气对慢性阻塞性肺疾病稳定期并肺心病患者右心功能的影响

Effect of family non-invasive ventilation on right heart function in patients with stable phase of chronic obstructive pulmonary disease complicated with cor pulmonale

目的探讨家庭无创通气对慢性阻塞性肺疾病(COPD)稳定期并肺心病患者右心功能的影响。方法选取2016年1月~2018年6月我院收治的120例COPD稳定期并肺心病患者作为研究对象,按照随机数字表法将其分为A组(60例)与B组(60例)。A组患者采用无创双水平正压通气,B组患者采用家庭无创通气。比较两组患者治疗前后肺动脉压力、右心室Tei指数、血气指标。结果两组患者治疗前的肺动脉压力、右心室Tei指数比较,差异无统计学意义(P>0.05);治疗后,B组患者的肺动脉压力为(53.89±0.05)mmHg,右心室Tei指数为(0.72±0.01),均低于A组的(59.48±1.32)mmHg、(0.79±0.02),差异有统计学意义(P<0.05)。两组患者治疗前的各项血气指标比较,差异无统计学意义(P>0.05);治疗后,两组患者的二氧化碳分压均低于治疗前,动脉血氧分压均高于治疗前,且B组患者的二氧化碳分压低于A组,动脉血氧分压高于A组,差异有统计学意义(P<0.05)。结论针对COPD稳定期合并肺心病患者,家庭无创通气可有效改善其右心功能,降低肺动脉压力,帮助患者提高良好呼吸功能,进而改善生活质量,值得临床应用与推广。

Objective To investigate the effect of family non-invasive ventilation on right heart function in patients with stable phase of chronic obstructive pulmonary disease(COPD)complicated with cor pulmonale.Methods A total of 120 patients with stable phase of COPD complicated with cor pulmonale admitted to our hospital from January 2016 to June 2018 were enrolled in the study.According to the random number table method,they were divided into group A(60 cases)and group B(60 cases).Non-invasive bi-level positive pressure ventilation was used in group A and non-invasive ventilation in group B was adopted.Pulmonary arterial pressure,right ventricular Tei index,and blood gas indexes were compared before and after treatment.Results There were no significant differences in pulmonary arterial pressure and right ventricular Tei index between the two groups before treatment(P>0.05).After treatment,the pulmonary arterial pressure in group B was(53.89±0.05)mmHg,and the right ventricular Tei index was(0.72±0.01),which were lower than those in group A for(59.48±1.32)mmHg and(0.79±0.02),with statistically significant differences(P<0.05).There were no significant differences in blood gas indexes between the two groups of patients before treatment(P>0.05).After treatment,the carbon dioxide partial pressure in both groups was lower than that before treatment,arterial blood oxygen partial pressure in both groups was higher than that before treatment,and the carbon dioxide partial pressure in group B was lower than that in group A,arterial blood oxygen partial pressure in group B was higher than that in group A,the differences were statistically significant(P<0.05).Conclusion Family non-invasive ventilation can effectively improve the right heart function,reduce pulmonary arterial pressure in patients with stable phase of COPD complicated with cor pulmonale,and help to improve their respiratory function,thereby improving quality of life,which is worthy of clinical application and promotion.